Postoperative visual loss due to conversion disorder after spine surgery: a case report

Bezerra, Dailson M.; Bezerra, Eglantine Mamede; Junior, Antonio Jorge Silva; Amorim, Marco Aurélio Soares; Miranda, Denismar Borges de

doi:10.1016/j.bjane.2015.03.005

Cited by 3 publications

(4 citation statements)

References 26 publications

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“…This is relatively common and may include diplopia, nystagmus, visual field defects, and complete visual loss in which no physical cause is identified. In our case there is a definite problem identified and successful treatment reversed the visual loss [13]. A case report of post spinal subdural hematoma has also been reported and evacuation was an effective treatment like in our case [14].…”

Section: Discussionsupporting

confidence: 59%

Bilateral Loss of Vision after Spinal Anaesthesia on a Dwarf Patient

Mw¹,

Jz²,

Na³

et al. 2019

Gen Med

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Achondroplasia is the most common form of dwarfism. Achondroplasia poses multiple anaesthetic challenges ranging from securing intravenous line, monitoring and drug dose calculations and airway management among others. Spinal anaesthesia is a very common method of anaesthesia in Botswana. The only type of anaesthetic drug that is in use for spinal anaesthesia in Botswana is hyper baric bupivacaine 0.5%. We report a case of a 33-year-old achondroplastic dwarf patient who developed bilateral visual loss for three days after he had received spinal anaesthesia for appendectomy. Postoperatively the patient was found to have increased intracranial pressure on magnetic resonance imaging scan. Subsequently decompressive ventriculo-peritoneal shunt operation was done and he gradually regained his vision. Meticulous and detailed pre anaesthetic assessment, well planned mode of anaesthesia and post-operative care of dwarf patients is essential to minimize complications and its severity. Postoperative signs and symptoms that may indicate any neurological effect of high intracranial pressure on dwarf patients have to be promptly identified and treated urgently to reduce further damage.

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Section: Discussionsupporting

confidence: 59%

Bilateral Loss of Vision after Spinal Anaesthesia on a Dwarf Patient

Mw¹,

Jz²,

Na³

et al. 2019

Gen Med

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“…We present a case of hemiparesis secondary to conversion disorder in the peri-operative period following a detailed and extensive neurologic, psychiatric and metabolic workup. While postoperative conversion disorders are rare occurrences in practice, previous published case studies have detailed similar clinical scenarios, each arriving at the diagnosis through exclusion of more common aetiologies of peri-operative neurological deficits such as stroke or residual paralysis [4][5][6][7][8][9]. There is currently uncertainty whether anaesthesia has a protective or causative role to play in the development of conversion disorder.…”

Section: Discussionmentioning

confidence: 99%

“…However, the interplay between peri-operative stress and conversion disorders is not fully understood. The current literature on peri-operative conversion disorders consists primarily of case reports where symptoms typically present postoperatively, highlighting the delay between a potential precipitating surgical or anaesthetic aetiology and the symptoms [4][5][6][7][8][9]. These cases, while rare, may be of interest to anaesthetists as patients with peri-operative conversion disorders may endure prolonged hospitalisation, increased utilisation of hospital resources to rule out more common diagnoses and a higher risk of iatrogenic errors [5].…”

Section: Introductionmentioning

confidence: 99%

Postoperative hemiparesis due to conversion disorder after moderate sedation: a case report

Jotwani

Turnbull

2020

Anaesthesia Reports

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Peri-operative conversion disorder that manifests as postoperative muscle weakness is an uncommon diagnosis made through exclusion of neurological, metabolic or iatrogenic aetiologies. We present a case where a patient with a considerable history of physical and psychological trauma suffered from prolonged right-sided hemiparesis following a breast biopsy under moderate-to-deep sedation. Conversion disorder following moderate-to-deep sedation has yet to be discussed in the literature, as all previous cases have described postoperative conversion disorder in the setting of general or central neuraxial anaesthesia. Our recommendation is for practitioners to keep conversion disorder on the list of differential diagnoses, despite the depth of sedation or type of anaesthetic utilised, and perform the same detailed neurological, metabolic and psychiatric assessment when considering postoperative weakness.

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“…And in high-risk patients, continuous monitoring of IOP during spinal and colorectal surgeries is crucial. Risk factors, such as prolonged surgeries, anemia, and direct ocular compression, should be carefully identified in the preoperative assessment [60]. Especially for patients with a history of glaucoma, the ophthalmologists should evaluate the IOP in positions specific to their surgery.…”

Section: Availability Of Triggerfish® Cls Application In the Spinal Amentioning

confidence: 99%

Outcome, influence factor and development of CLS measurement in continuous IOP monitoring: A narrative review

Chen

Lin

et al. 2020

Contact Lens and Anterior Eye

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A large fluctuation in intraocular pressure (IOP) and a high peak IOP remain the risk factors for progressive visual field loss in patients with glaucoma, which is a leading cause of irreversible blindness. However, IOP measurements during working time cannot provide sufficient information on IOP to guide clinicians in setting IOP target values. Contact lenses are extensively used in ophthalmology to correct the refractive error, and recently, they are serving as platforms for detection and drug delivery. Contact lens sensor (CLS) is a feasible and promising approach to continuously monitor IOP, with superior tolerance, non-invasiveness, and without sleep disturbance. The present work reviewed the associations between progressive course and Triggerfish® CLS outputs as well as the relationship between treatments and Triggerfish® CLS outputs. Moreover, it further summarized state-of-the-art CLS devices of the past decade.

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Postoperative visual loss due to conversion disorder after spine surgery: a case report

Cited by 3 publications

References 26 publications

Bilateral Loss of Vision after Spinal Anaesthesia on a Dwarf Patient

Bilateral Loss of Vision after Spinal Anaesthesia on a Dwarf Patient

Postoperative hemiparesis due to conversion disorder after moderate sedation: a case report

Outcome, influence factor and development of CLS measurement in continuous IOP monitoring: A narrative review

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